The Influence of Social-Communicative Skills on the General Development of Toddlers with Autism Spectrum Disorder (ASD)

Background:  

The early social-communicative skills imitation, joint attention, and pretend play are considered to be pivotal skills in the development in children with autism spectrum disorder (ASD). Children with ASD exhibit significant deficits in the development of these three skills. Previous research indicated that these skills are important precursors of later language, social competence, and general development.

Objectives:

The first goal of this research was to determine which specific aspects of the three social-communicative skills differ in children with and without a clinical diagnosis of ASD, recruited from a group of children with a positive screen for ASD at a younger age. Secondly, this study wanted to reveal which of these aspects correlate with general development simultaneously and one year later.

Methods:  

In this study, the three social-communicative skills were investigated in a group of 3-year-olds with (n=13) and without (false positives; n=24) a clinical diagnosis of ASD. Imitation was examined using the Preschool Imitation Praxis Scale (PIPS; Vanvuchelen, 2009). Joint attention skills were measured with the Early Social Communication Scales (ESCS; Mundy et al., 2003), and pretend play was assessed using the Test of Pretend Play (ToPP; Lewis & Boucher, 1997). The general development of all children was examined at the ages of 3 and 4, using the Mullen Scales of Early Learning (MSEL; Mullen, 1995).

Results:  

Adopting a multivariate analysis of variance, significant group differences were found for the variables pretend play, bodily and procedural imitation, and response to joint attention. Positive correlations were observed between the Early Learning Composite score of the Mullen measured at age 3 and age 4 and the social-communicative skills response to joint attention, response to behavioural request, pretend play, bodily and procedural imitation. Hierarchical analyses with these results revealed that procedural imitation, measured at age 3, significantly predicts the Early Learning Composite measured at age 4. Further, these hierarchical analyses brought to light that the group differences based on clinical diagnosis disappeared when other variables were added to the model. In order to investigate whether this effect is mediated by the effect of the other variables, mediation analyses were executed. For this analyses, bootstrapping methods were used (Preacher & Hayes, 2008). Results revealed that the effect of the variable ‘having a clinical diagnosis ASD’ is mediated by pretend play and procedural imitation.

Conclusions:  

This study confirmed previous results concerning differences in the development of the three social-communicative skills between children with and without ASD. Significant differences were observed for the skills pretend play, bodily and procedural imitation, and response to joint attention. However, certain aspects of the three social-communicative skills do not differ between children with ASD and false positives. Moreover, differences in general development between children with ASD and false positives can be explained by a different development of procedural imitation and pretend play.